NUR313 Evolve: AQ 16 - Drugs for Angina Pectoris and Management of STEMI
What does the nurse instruct a patient, who is prescribed nitroglycerin patches do to prevent the development of tolerance to nitrates?
"Apply the nitroglycerin patch each day, and remove it for 10 hours at night."
Which adverse effect is the greatest concern with thrombolytic therapy?
Intracranial hemorrhage.
The nurse is teaching a patient who has had an ST-segment elevation myocardial infarction about home medications. Which agent represents a drug category that should be taken by all post-myocardial infarction (post-MI) patients unless contraindicated?
Metoprolol.
Which instruction will be included in the discharge teaching for a patient with a transdermal nitroglycerin patch?
"Apply the patch to a hairless, nonfatty area of the upper torso or arm."
Which statement made by a patient about nitroglycerin indicates understanding?
"I will keep the nitroglycerin stored in the bottle it comes in."
The nurse is providing discharge teaching for a patient with a new prescription for a nitroglycerin transdermal patch. Which statement by the patient indicates a need for further teaching?
"I will limit my alcohol to one drink per day."
Which drugs are included in the treatment plan to minimize possible myocardial necrosis while awaiting definitive diagnosis of ST-elevation myocardial infarction (STEMI)? Select all that apply.
-Aspirin. -Morphine. -Beta-blockers. -Nitroglycerine.
Which classes of drugs are used in the treatment of angina pectoris? Select all that apply.
-Nitrates. -Beta blockers. -Calcium channel blockers.
Which are types of chest pain? Select all that apply.
-Unstable angina. -Vasospastic angina. -Chronic stable angina.
Which patient will be given nitroglycerin?
A patient with coronary heart disease who complains of chest pain.
A patient is receiving isosorbide dinitrate 20 mg 3 times per day for management of newly diagnosed stable angina. Which assessment finding would require an immediate nursing intervention?
An increase in the resting heart rate to 110 beats/min from baseline rate of 72 beats/min.
What instruction should the nurse provide to the patient who needs to apply nitroglycerin ointment?
Apply the ointment to a nonhairy part of the upper torso.
Before the nurse administers isosorbide mononitrate, what is a priority nursing assessment?
Assess blood pressure.
What is the primary cause of ischemic heart disease in a patient?
Atherosclerosis.
The nurse is caring for a patient who is receiving enteral feedings because of dysphagia. The health care provider prescribes isosorbide mononitrate 60 mg SR daily via the enteral tube. What is the most appropriate action by the nurse?
Call the health care provider about an alternative form of nitrate for administration.
Which assessment finding could indicate a myocardial infarction (MI) in a patient who is taking nitroglycerin for angina?
Chest pain is not relieved by administering nitroglycerin.
The nurse is monitoring a patient during intravenous (IV) nitroglycerin infusion. Which assessment finding will cause the nurse to take action?
Chest pain.
A patient is admitted to the emergency department with a diagnosis of ST-segment elevation myocardial infarction (STEMI). Which is the priority nursing action?
Having the patient chew a 325-mg aspirin.
Which assessment finding in a patient with cardiac risk factors needs to be reported if the patient is taking a nonselective beta blocker?
History of asthma.
The nurse is monitoring a patient receiving ranolazine for angina. Which assessment finding indicates an adverse effect of this drug?
QT prolongation on the electrocardiogram (ECG).
Which is the most beneficial treatment for patients experiencing an ST-segment elevation myocardial infarction?
Reperfusion therapy.
A patient who is prescribed sublingual nitroglycerin reports after 6 months that she left the bottle in her car for a few weeks. The nurse instructs the patient to obtain a new prescription from the primary health care provider. What is the purpose of obtaining a new prescription?
The drug has lost its potency.
What is the duration of action of a nitroglycerin transdermal patch?
Up to 24 hours.
The nurse is caring for a patient receiving nitrates for relief of angina. Which pharmacodynamic action is responsible for the relief of anginal pain with nitrates?
Vasodilation leads to decreased preload, which decreases oxygen demand.
What is the most appropriate outcome criteria for a patient who has been prescribed a calcium channel blocker?
Absence of chest pain.
Which patient assessment would assist the nurse in evaluating the therapeutic effects of a calcium channel blocker?
Absence of chest pain.
Which medication is the treatment of choice for ST-segment elevation myocardial infarction (STEMI)-associated pain?
Morphine.
Which form of nitroglycerin is likely to have a large first-pass effect?
Oral.
